Malpractice lawsuits in medicine and facial surgery are on the rise and they become an influencing factor in everyday practice for any surgeon.

We aim to analyze the possible causes for litigation in an effort to avoid these claims in the future.

One hundred and thirty litigation cases filed over a 10 year period (2005–2015) were evaluated.

Depending on the expert's opinion, it was determined whether the lawsuit was due to actual faulty treatment or either a lack of informed consent or discrepancy between the expected and the final result.

A total of 136 claims were filed and examined. Dissatisfaction about the esthetic or functional result topped the list with 47% (n = 64) of the cases followed by nerve damage with 20% (n = 27). Medical negligence and failed treatment accounted both for 9% of all cases (n = 12). The list was completed by post-operative complications (n = 11), death (n = 6) and incorrect or late diagnosis (n = 4). In the expert's opinion only in 21 (15%) cases there was actual fault and in the remaining cases litigation was due to lack of informed consent (n = 70; 51%) or a discrepancy between the expected and achieved result (n = 45; 33%).

A considerable portion of the lawsuits in facial surgery seem to originate out of a lack of communication between physician and patient and not faulty treatment. Efforts in informing the patient about possible side effects, complications and expectations will benefit the physician greatly by minimizing his liability and risk at prosecution.